Adequate intakes

Increased amounts are required during pregnancy and lactation. Adequate intake with adequate intake of protein. 

Sodium Intake. Where salt is readily available, most of the world s population chooses to consume about 6,000—11,000 mg of salt or sodium chloride a day so that average daily sodium intake from all sources is 3,450 mg (8,770 mg NaCl) (13). The U.S. EDA s GRAS review puts the amount of naturally occurring sodium in the American diet at 1000—1500 mg/d, equivalent to the amount of sodium in approximately 2500—3800 mg NaCl. Thus the average daily intake of NaCl from food-grade salt used in food processing (qv) and from salt added in cooking or at the table is from 4960—6230 mg NaCl. The requirement for salt in the diet has not been precisely estabUshed, but the safe and adequate intake for adults is reported as 1875—5625 mg (14). The National Academy of Sciences recommends that Americans consume a minimum of 500 mg/d of sodium (1250 mg/d salt) (6,15). 

Agriculture. Most forages provide insufficient sodium for animal feeding and may lack adequate chloride. Thus salt supplementation is a critical part of a nutritionally balanced diet for animals. In addition, because animals have a definite appetite for salt, it can be used as a deflvery mechanism to ensure adequate intake of less palatable nutrients and as a feed limiter. Salt is an excellent carrier for trace minerals. Salt, either in loose form or as compressed blocks, can be mixed with feed or fed free-choice to improve animal health and productivity (see Feeds and feed additives). 

The expected outcomes for the patient may include an optimal response to therapy, management of common adverse reactions, an absence of diarrhea, maintenance of an adequate intake of fluids, maintenance of adequate nutrition, an understanding of the therapeutic regimen (hospitalized patients), and an understanding of and compliance with the prescribed therapeutic regimen (outpatients). 

Pellagra Can Occur as a Result of Disease Despite an Adequate Intake of Tryptophan Niacin... 

A number of genetic diseases that result in defects of tryptophan metabolism are associated with the development of pellagra despite an apparently adequate intake of both tryptophan and niacin. Hartnup disease is a rare genetic condition in which there is a defect of the membrane transport mechanism for tryptophan, resulting in large losses due to intestinal malabsorption and failure of the renal resorption mechanism. In carcinoid syndrome there is metastasis of a primary liver tumor of enterochromaffin cells which synthesize 5-hydroxy-tryptamine. Overproduction of 5-hydroxytryptamine may account for as much as 60% of the body s tryptophan metabolism, causing pellagra because of the diversion away from NAD synthesis. 

Many of the essential minerals (Table 45—2) are widely distributed in foods, and most people eating a normal mixed diet are fikely to receive adequate intakes. The... 

Bacteria cause disease of the gut as a result of either mucosal invasion or toxin produchon or a combinahon of the two mechanisms as summarized in Table 6.4. Treatment is largely directed at replacing and maintaining an adequate intake of fluid and electrolytes. Anhbiohcs are generally not recommended for infechve gastroenterihs. 

If the concepts and facts presented in this paper are correct, a major kind of human cancer in many regions of the world, cancer of the stomach, is due to a type of nitroso compound, a nitrosoureido derivative, even though not a nitrosamine It is quite certain that the formation of such compounds can be blocked by vitamin C and vitamin E, as well as by some other substances such as gallates Thus, the primary prevention of cancer caused by nitroso compounds is readily accomplished through an adequate Intake of such harmless inhibitors with every meal from infancy onwards ... 

Polymeric formulas typically have low osmolality of 300 to 500 mOsm/kg. These formulas also usually supply essential vitamins and minerals in amounts similar to the Adequate Intakes or Recommended Dietary Allowances for these nutrients when the formula is delivered in amounts adequate to meet the macronutrient requirements of most patients. Many polymeric formulas are inexpensive relative to oligomeric formulas. Most polymeric formulas are lactose-free and gluten-free, as are most modern tube feeding products. Products designed to be used as oral supplements generally are polymeric and often have sucrose or other simple sugars added to improve taste. 

All individuals should have a balanced diet with adequate intake of calcium and vitamin D (Table 3-1). Table 3-2 lists dietary sources of calcium and vitamin D. If adequate dietary intake cannot be achieved, calcium supplements are necessary. 

Group and Ages Institute of Medicine Adequate Intake Elemental Calami (mgf Vitamin D (mibf ... 

Most experts believe the recommended adequate intakes for vitamin D are too low. 

Calcium Adequate intake (Table 3-1) in divided doses Absorption-predominantly active transport with some passive diffusion, fractional absorption 10-60%, fecal elimination for the unabsorbed and renal elimination for the absorbed calcium... 

D3 (cholecaldferol) Adequate intake (Table 3-1) if malabsorption or Hepatic metabolism to 25(OH)... 

F, female M, male RDA, recommended dietary allowance. 0 Adequate intake. 

See also ATP entries hydrolysis of, 16 553 20 641 production of, 13 288 Adenosylcobalamin, 25 804 Adenoviruses, 3 136 Adequate Intake (AI), 25 784, 785t Adern, E., 11 8 Adherends, 1 501, 524 Adhesion, 1 501-524. See also Adhesive entries Pressure-sensitive adhesives (PSAs)... 

According to food composition tables, the diets used in the study provided an adequate intake of the essential nutrients. Each day, an exact amount of each food served the subjects was saved for analysis of nitrogen, calcium, and sulfur (as sulfate). The results for these elements agreed with those in the literature. These results indicated that during the soy diet, mean intakes were 78.5 g protein, 456 mg calcium, and 2305 mg. of sulfur. Intakes in the meat period were within 37o of those of the soy period. 

Vitamins occur naturally in many foods and raw materials. However the natural contents are often supplemented in many food products to ensure an adequate intake, for example in infant formulae, breakfast cereals and clinical nutrition products. Vitamins are usually added as nutrients and thus not covered in this chapter but may also be added as food colours (riboflavin, carotenes). The reader should refer to the following references for recent developments in... 

We cannot live without the essential nutrients. The absence of vitamins and minerals from our diet threatens survival. Thus, the health risk of nutritional inadequacy (which takes many forms, depending upon the nutrient) is large at zero intake, and then decreases as intake increases risks are minimal when nutritionally adequate intakes are achieved (there are several measures of adequacy, not described here). 

Furthermore, the two pathways that normally degrade homocysteine are absent from the neurone and glial cells and so homocysteine can accumulate in the brain (Chapter 8, Appendix 8.2). Consequently, the maintenance of adequate intake of folic acid and vitamin over many years, to ensure low levels of homocysteine, may help to protect neurones and reduce the risk of development Alzheimer s disease. 

Mouth, pharynx, oesophagus Alcohol Adequate intake of fruit,... 

Dietary Reference Intakes (DRIs) refer to nutrient intake values estimated to be adequate for 50% of age- and gender-specific groups. As seen in the table below, DRIs are comprised of RDAs in bold type and Adequate Intakes (Als) in ordinary type followed by asterisk ( ). These values may be used as goals for individual intake. RDAs are estimated to meet the needs of most individuals (97% to 98%). For healthy breast-fed infants, the Al represents mean intake. For all other life-stage groups, the Al is believed to cover the needs of all individuals, but a lack of data or uncertainty in the data prevent specifying with confidence with percentage of individuals covered by this intake. 

Nutrition Patients should maintain adequate nutrition, particularly an adequate intake of calcium and vitamin D. 

TABLE 6.2 Criteria upon which Adequate Intake (Al) values were based for calcium by life stage groups"... 

Gao, X., Wilde, P. E., Lichtenstein, A. H., and Tucker, K. L. (2006). Meeting adequate intake for dietary calcium without dairy foods in adolescents aged 9 to 18 years (National Health and Nutrition Examination Survey 2001-2002). /. Am. Diet. Assoc. 106,1759. 

Storey, M. L., Forshee, R. A., and Anderson, P. A. (2004). Associations of adequate intake of calcium with diet, beverage consumption, and demographic characteristics among children and adolescents. J. Am. Coll. Nutr. 23,18-33. 

Reference Intakes (DRIs). In the past, the recommended dietary allowances (RDAs), which are the levels of intake of essential nutrients that are considered to be adequate to meet the known nutritional needs of practically all healthy persons, were the primary reference value for vitamins and other nutrients. The DRIs also include other reference values, such as the estimated average requirement (EAR) and the adequate intake (AI). The RDA, EAR, and AI reference standards define nutritional intake adequacy. Since these recommendations are given for healthy populations in general and not for individuals, special problems, such as premature birth, inherited metabolic disorders, infections, chronic disease, and use of medications, are not covered by the requirements. Separate RDAs have been developed for pregnant and lactating women. Vitamin supplementation may be required by patients with special conditions and for those who do not consume an appropriate diet. 

A varied diet containing a wide range of foodstuffs provides adequate intake of vitamins for most people, and supplementing these amounts will have no beneficial effect and may result in the toxicity associated with hypervitaminosis. The DRI also includes the tolerable... 

Fluorine is ubiquitous in the nature and is consequently an inevitable part of the biosphere and human life. The adequate intake (Al) of fluoride ion from all sources is set at... 

Fluorine is available to humans, plants and animals mainly in the form of fluoride ion (F ). Body fluoride status depends on numerous factors, including the total amount of fluoride ingested daily, its bioavailability and metabolism. The adequate intake (Al) of fluoride from all sources is set by the Standing Committee on the Scientific Evaluation of the Dietary Reference Intakes at 0.05 mg/day/kg body weight this intake is recommended for all ages above 6 months, because it confers a high level of protection against dental caries and is not associated with any known unwanted health effects [8]. 

This paper is written with the aim of providing sufficient background to help understand the mechanism of action of fluoride ion on humans. The main focus is on the effects of fluoride on dental health, in-depth discussion of skeletal fluorosis and use of fluoride for treating osteoporosis being outside the scope of this paper. Current information on the main sources of human exposure to fluoride and current recommendations for adequate intake (Al) of fluoride, as well as methods for assessing exposure, will be reviewed. 

Table 9. Overview of adequate intakes (Als) for fluoride by age groups based on an Al for fluoride of 0.05 mg/day/kg body weight from all sources [8]...

Inorganic Calcium Salts. Adequate intake of Ca + salts in adolescence and early adulthood should increase bone mineral density, subsequently, in theory, reducing risk... 

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